Mohs micrographic surgery, commonly known as Mohs surgery, is a specialized, precise technique for treating certain types of skin cancer. Developed by Dr. Frederic Mohs, the procedure involves the systematic removal and immediate examination of cancerous tissue, layer by layer, directly in the surgeon’s office. This methodical approach differs from standard surgical excision, which removes the tumor and a wider, predetermined margin of healthy tissue. Mohs is considered the standard treatment for many non-melanoma skin cancers.
Unmatched Cure Rates
The documented success of Mohs surgery in eliminating skin cancer is a primary benefit. For previously untreated basal cell carcinoma (BCC), the five-year cure rate reaches up to 99%. Similarly impressive results are seen for primary squamous cell carcinoma (SCC), with reported cure rates ranging from 92% to 99%. This efficacy is significantly higher than traditional surgical excision, which has a higher rate of recurrence for certain tumors. Even for skin cancers that have returned after previous treatment, Mohs surgery maintains a success rate of approximately 94% to 97%.
Maximum Preservation of Healthy Tissue
Mohs surgery is designed to maximize tumor removal while conserving the greatest amount of surrounding healthy skin. Unlike conventional excision, Mohs surgery is microscopically guided. The surgeon removes only the tissue necessary to clear the tumor, sparing healthy tissue that would otherwise be removed. This meticulous tissue sparing is particularly beneficial when the cancer is located on cosmetically sensitive or functionally important areas. The face, nose, lips, eyelids, ears, hands, and feet are prime examples. Preserving more healthy tissue leads to smaller surgical wounds and less noticeable scars after reconstruction.
Real-Time Cancer Clearance Assurance
The procedural flow of Mohs surgery provides immediate assurance that the cancer has been entirely removed before the surgical wound is closed. The Mohs surgeon acts as both the operating surgeon and the pathologist during the procedure. After the first thin layer of tissue is removed, it is immediately frozen, precisely mapped, and microscopically examined. This specialized process allows the surgeon to analyze 100% of the surgical margin. If cancer cells are detected, the surgeon returns only to the exact mapped location and removes another thin layer of tissue. This staged process continues in real-time until a cancer-free margin is confirmed. This immediate analysis eliminates the uncertainty of traditional excision, where results may take several days, potentially necessitating a second surgery.
Essential for Complex and Recurrent Tumors
Mohs surgery is often necessary for tumors that present specific challenges. This includes skin cancers that have recurred after previous treatment, which often have complex, irregular growth patterns beneath the surface. Tumors with aggressive features, such as infiltrative or morpheaform growth patterns, require the microscopic control offered by Mohs. The technique is also the preferred option for large tumors or those with clinically indistinct borders. In these complex cases, the precise, layer-by-layer mapping ensures that the surgeon can track the deepest extensions of the cancer. Achieving complete clearance while minimizing tissue loss is important when dealing with tumors that carry a higher risk of further spread or damage to surrounding structures.